Prison and Drugs: State often denies help, then isolates in-prison users

New Yorkers may be shocked to hear that illicit drug use is widespread in our state prisons. But even more shocking is the punishment for prisoners using or possessing drugs: months, even years, of solitary and near-solitary confinement in what prisoners call "the box." And with no sense of irony, New York prohibits prisoners in the box from participating in drug treatment programs.

Meet Nathan. He was identified as needing drug treatment when he entered the New York state prison system with a 16-year sentence. But because prisoners close to their release date get treatment first, Nathan faced the possibility of years in prison without help for his drug problem.

When he continued using drugs in prison, he was sentenced to the box, though no violent or other disruptive behavior was involved. With each relapse, he received harsher punishment. When we interviewed Nathan, eight years after he entered prison, he was serving a 34-month sentence in the box -- 14 months for one drug-related incident and 20 months for another. He had never received any drug treatment.

In New York, prison officials say that three of four inmates need substance abuse treatment. Treatment programs are filled to capacity. As inmates wait months, even years, for treatment, many are caught in a Catch-22: at high risk of relapse, but punished and denied access to treatment if they do.

Inmates told Human Rights Watch that drugs are as available in prison as in the street. In this respect, New York is not unique. Drug use in prison is a reality worldwide. But for many, a disciplinary "ticket" for drugs triggers a cycle of severe punishment that starts with losing their place on the waiting list for treatment. An inmate sent to disciplinary confinement is further than ever from getting help. Documents obtained from the Department of Correctional Services show that between 2005 and 2007, New York inmates were sentenced to a collective total of 2,561 years in the box for drug-related charges.

In the box, Nathan is locked down 23 hours a day. His food is delivered through a slot in the door. Nathan's visitors, telephone calls, letters, even his shower privileges are severely restricted. In recent years, Human Rights Watch has documented the negative mental and physical effects of these "supermax" conditions on prisoners. Nathan told us that he was "hearing voices, the walls are closing in on me, I don't know if I can take it much longer." For Nathan, there is no end, and no treatment, in sight.

These policies make no sense either for public health or security. Prison drug treatment is cost-effective, saving $2-$6 in health care and re-incarceration costs for every dollar invested. Leaving drug dependent prisoners untreated simply raises demand for drugs in the prisons. Drug treatment, on the other hand, has been shown to make prisons more secure. The state Legislature recently passed a budget that expands prison drug treatment as part of Rockefeller Drug Law reform. But the disciplinary system needs to be reformed as well.

A long period of isolation is a disproportionate sentence for any prisoner who uses drugs. But for prisoners struggling with addiction, the punishment of the symptoms of a chronic, relapsing disease, combined with a denial of treatment, is cruel, inhuman and degrading treatment that violates international law -- and basic human decency.

Megan McLemore is a researcher at Human Rights Watch in New York City and the author of "Barred from Treatment: Punishment of Drug Users in New York State Prisons."

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